The invention relates to a bandage for the ankle joint.
Depending on their design and on the indications for which they are intended, orthopaedic bandages exert a fixing, guiding, bracing and/or supporting action on the extremities of the human body.
These medical bandages must have a shape which corresponds to the anatomical circumstances in order to be able to act externally on the human body with a form fit and a force fit.
Medical bandages of this kind are produced by cutting out blanks from planar material, for example neoprene, knitted fabrics or woven fabrics. The anatomically appropriate shape is obtained via the shape of the blanks or darts, for example with gussets, and subsequent joining together of the blanks, as is also customary in articles of clothing.
This joining together can be done by sewing, gluing or other conventional methods. The great disadvantage of these bandages is that the exact anatomical fit can be achieved only with difficulty and there are a large number of connection points, for example seams. These connection points change the properties of the material used, and there is the danger of pressure points on the skin.
Ankle joint ortheses or bandages are used preferably for the early functional treatment of recent fibular ligament ruptures and of mild and moderately severe tarsal distortions, and are also used in cases of chronic instability.
DE-A-38 40 714 discloses an ankle joint orthesis with a U-shaped support stirrup, the branches of which run together to form a bridge under the foot, reach upwards across the malleoli and are held together in their end region by a securing tape. The outer branch is in this case guided upwards laterally in front of its malleolus, and the inner branch opposite the outer branch is guided upwards in front of the Achilles tendon. Both branches, in the direction towards the bridge, are guided to a position in front of the heel, and, in the direction towards their ends, they extend upwards in such a way that they ascend laterally along the tibial ridges and approximately parallel to these, and a holding tape is arranged in the lower area of the branches, which holding tape extends from the one branch obliquely upwards across the instep to the other branch, and can be fastened thereon, engages above the malleoli about the Achilles tendon and, overlapping on the instep, ends on the other branch in a holding part. An ankle joint orthesis designed in this way is intended to prevent twisting, primarily in the lateral anterior direction, that is to say in the direction of a talipes equinus position. Since the U-shaped support stirrup of this ankle joint orthesis has its outer branch guided upwards laterally in front of the malleolus and has its inner branch guided upwards in front of the Achilles tendon, and is held together by a bridge running under the foot, the medial margin of the metatarsus is not gripped, with the result that the use of this ankle joint orthesis is limited.
DE-A-39 09 922 describes a foot fixation splint. This foot fixation splint is used in particular for the postoperative treatment of an injured ankle joint, with a foot part which surrounds the foot and to which there is joined a holding part extending upwards into the calf area and provided with closure straps. The holding part is in this case divided into two side parts which are joined to the foot part and are of cup-shaped design. The area of each side part covering the malleolus is provided with a window-type recess. The area of the Achilles tendon on the foot part and on the holding part is in this case left open. The adjustable and fixable tape-like closure straps are made of an inextensible material, and one closure strap is arranged on the foot part in such a way that it engages over the back of the foot and so fixes the first radius of the metatarsus against supinatory elevation. A foot fixation splint of this kind is intended, on the one hand, to ensure a satisfactory immobilization of the foot that is to be treated, and, on the other hand, to avoid the disadvantages of a plaster cast, since after injuries and operations involving the external ligament apparatus, the foot is often put in plaster in order to immobilize it, and postoperative treatment of operation wounds is not possible on account of a great many serious disadvantages. In the case of this foot fixation splint, the starting point is a U-shaped joint cuff with a full-surface sole part which covers the middle and front portions of the foot as far as the ball of the small toe, but which does not provide sufficient suppleness in the metatarsal area.
DE-C-43 18 588 likewise discloses an ankle joint orthosis consisting of a U-shaped joint cuff which is made of thermoplastic material and is composed of an outer malleolar splint and an inner malleolar splint. These malleolar splints are connected via a bridge running underneath the heel. The malleolar splints additionally have anatomically correct depressions for adaptation to the malleolar contours and for a correct anatomical fit. A further element of the orthesis is its metatarsal part, which is likewise made of thermoplastic material. This part of the orthesis runs obliquely under the sole of the foot, proximal to the capitula of metatarsals I-V, and is formed into a loop shape medially and laterally. The loops thus formed enclose the outer and inner margins of the foot. They guide the metatarsus on the one hand, and on the other hand serve for securing cross and transverse belts. The metatarsal part is in this case connected on the sole side by a bridge which is again made of thermoplastic material but is highly flexible. This bridge has the function of an articulation and acts analogously to an integral hinge. The pivot axis of this articulation formed in the highly flexible bridge runs from dorsomedial to anterolateral and forms with the long axis of the foot an angle of approximately 10xc2x0, in accordance with the anatomy of the lower part of the ankle joint.
The invention is based on the object of providing a bandage which is intended to be used in particular on the ankle joint and which as such is suitable for functional treatment of mild and moderately severe distortions of the tarsus and chronic instabilities, and with which a lateral and medial stabilization of the upper and lower part of the ankle joint is achieved, which reduces the risk both of inversion trauma and of eversion trauma.
This object is achieved by means of the bandage of the invention.
In accordance with the invention, the bandage for the ankle joint consists of an elongate strip and of a strap secured on the elongate strip. The first transverse edge of the strip is arranged essentially vertically on the medial side of the ankle joint. Starting from the first transverse edge, the elongate strip is guided round the heel, across the lateral side of the ankle joint, across the back of the foot in the medial-plantar direction and across the sole of the foot in the lateral-plantar direction. The first transverse edge of the elongate strip is secured, preferably stitched, on the elongate strip itself. In a preferred embodiment, the first transverse edge of the elongate strip is secured across its entire width on the elongate strip.
Also joined to the second transverse edge is the strap which is guided from the lateral side of the sole of the foot across the back of the foot to the medial side of the ankle joint, round the heel to the lateral side of the ankle joint and across the lateral side of the ankle joint and is secured.
This described type of arrangement of the elongate strip has the effect that the elongate strip is presented in a helical form, with approximately two thread turns, and is preferably stitched, so that a hollow interior is formed inside the bandage for receiving the foot. It is also possible, however, for the second transverse edge to be secured on the elongate strip.
In a preferred embodiment, the elongate strip has a transverse elasticity of 0% to 100%, in particular 5% to 30%, and a longitudinal elasticity of 30% to 250%, in particular 80% to 120%.
In a further preferred embodiment, the strap has a transverse elasticity of 0% to 100%, in particular 5% to 30%, and a longitudinal elasticity of 30% to 250%, in particular 50% to 100%.
It has proven particularly advantageous if the elongate strip is approximately 40 to 60 cm long and the strap is approximately 25 to 40 cm long, and if the elongate strip is approximately 8 to 12 cm wide and the strap is approximately 6 to 10 cm wide.
In a further preferred embodiment of the bandage, the second transverse edge is secured on the elongate strip at least with the proximal end and the strap is joined to the second transverse edge.
An embodiment is also preferred in which the second transverse edge is secured completely on the elongate strip and the strap is also joined to the second transverse edge.
The construction of the bandage according to the invention means that the elongate strip and the strap can be made of the same material and in particular can be punched out in a single blank. By means of the features of the bandage according to the invention, the said bandage effects a circular compression and a lateral and medial stabilization of the upper part of the ankle joint and the lower part of the ankle joint, which means that the risk of both inversion trauma and also eversion trauma is reduced.
The bandage permits a high degree of mobilization, as is necessary for functional treatment of the ankle joint; however, it also guarantees, by means of the defined, limited elasticity, a reliable stabilization of the injured ankle joint. The bandage is therefore particularly suitable for functional treatment of mild and moderately severe tarsal distortions and chronic instabilities.
The invention will be explained in greater detail with reference to four diagrammatic drawings showing an illustrative embodiment, namely the design for the left foot, without thereby wishing to restrict the invention unnecessarily. The design version of the bandage for the right foot is mirror-symmetrical to the first. In the preferred embodiment, the bandage can be converted from the left-foot version to the right-foot version by turning it inside out.